Melatonin enhances vertical bone augmentation in rat calvaria secluded spaces.

Melatonin enhances vertical bone augmentation in rat calvaria secluded spaces.

Med Oral Patol Oral Cir Bucal. 2015 Nov 22;:0

Authors: Shino H, Hasuike A, Arai Y, Honda M, Isokawa K, Sato S

Abstract
BACKGROUND: Melatonin has many roles, including bone remodeling and osseointegration of dental implants. The topical application of melatonin facilitated bone regeneration in bone defects. We evaluated the effects of topical application of melatonin on vertical bone augmentation in rat calvaria secluded spaces.
MATERIAL AND METHODS: In total, 12 male Fischer rats were used and two plastic caps were fixed in the calvarium. One plastic cap was filled with melatonin powder and the other was left empty.
RESULTS: Newly generated bone at bone defects and within the plastic caps was evaluated using micro-CT and histological sections. New bone regeneration within the plastic cap was increased significantly in the melatonin versus the control group.
CONCLUSIONS: Melatonin promoted vertical bone regeneration in rat calvaria in the secluded space within the plastic cap.

PMID: 26595835 [PubMed - as supplied by publisher]

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Bacterial inactivation/sterilization by argon plasma treatment on contaminated titanium implant surfaces: In vitro study.

Bacterial inactivation/sterilization by argon plasma treatment on contaminated titanium implant surfaces: In vitro study.

Med Oral Patol Oral Cir Bucal. 2015 Nov 22;:0

Authors: Annunziata M, Canullo L, Donnarumma G, Caputo P, Nastri L, Guida L

Abstract
BACKGROUND: Surface treatment by argon plasma is widely used as the last step of the manufacturing process of titanium implant fixtures before their sterilization by gamma rays. The possibility of using such a technology in the daily clinical practice is particularly fascinating. The aim of the present study was to assess the effects of the argon plasma treatment on different titanium implant surfaces previously exposed in vitro to bacterial contamination.
MATERIAL AND METHODS: Sterile c.p. titanium implant discs with turned (T, Sa: 0.8μm), sandblasted/acid-etched (SAE, Sa: 1.3μm) and titanium plasma sprayed (TPS, Sa: 3.0μm) surface were used in this study. A strain of Aggregatibacter actinomycetemcomitans ATCC3718 was grown at 37°C under anaerobic conditions for 24 h and then transferred on six discs for each of the three surface types. After 24 hours, a half of the contaminated discs (control group) were directly used to evaluate the colony forming units (CFUs). The other half of the contaminated discs (test group) were treated in an argon plasma chamber for 12 minutes at room temperature prior to be analyzed for CFU counting. All assays were performed using triplicate samples of each material in 3 different experiments.
RESULTS: When the CFU counting was carried out on control discs, a total of 1.50x106±1.4x105, 1.55x106±7.07x104 and 3.15x106±2.12x105 CFU was respectively assessed for T, SAE and TPS discs, without statistically significant differences among the three surfaces. On the contrary, any trace of bacterial contamination was assessed for titanium discs treated in the argon plasma chamber prior to be analyzed, irrespectively to the implant surface tested.
CONCLUSIONS: Within the limit of this study, reported data suggested that the argon plasma technology could be efficiently used to decontaminate/sterilize previously infected titanium implant surfaces.

PMID: 26595834 [PubMed - as supplied by publisher]

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The isolated orbital floor fracture from a transconjunctival or subciliary perspective-A standardized anthropometric evaluation.

The isolated orbital floor fracture from a transconjunctival or subciliary perspective-A standardized anthropometric evaluation.

Med Oral Patol Oral Cir Bucal. 2015 Nov 22;:0

Authors: Raschke G, Djedovic G, Peisker A, Wohlrath R, Rieger U, Guentsch A, Gomez-Dammeier M, Schultze-Mosgau S

Abstract
BACKGROUND: The influence of orbital fractures and their repair on the rate of deformities of the lower eyelid is an ongoing source of discussion in the literature. Most of the present studies include isolated blow-out as well as combined orbital fractures.
MATERIAL AND METHODS: We present a retrospective evaluation of a series of 100 patients after isolated blow-out fracture repair using reference anthropometric data on standardized photographs. Analysis included eye fissure width and height, lid sulcus height, upper lid height, upper and lower iris coverage, position of cornea to palpebra inferior, canthal tilt, scleral show, ectropion and entropion. It was clearly distinguished between operated and contralateral eyelid, whether a transconjunctival or a subciliary approach was performed and amount of fracture. Our main interests were changes of the aforementioned parameters with regards to eyelid deformities.
RESULTS: Surgery per se did not significantly influence eyelid deformities. However, the surgical approach selected significantly affected eye fissure index, lower iris coverage and rate of scleral show, indicating retraction of the lower eyelid.
CONCLUSIONS: The standardized measurements described here are accurate and objective to evaluate postoperative results. The subciliary approach included the highest risk of lower lid retraction as compared to transconjunctival approaches.

PMID: 26595833 [PubMed - as supplied by publisher]

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Multidisciplinary management of ankyloglossia in childhood. Treatment of 101 cases. A protocol.

Multidisciplinary management of ankyloglossia in childhood. Treatment of 101 cases. A protocol.

Med Oral Patol Oral Cir Bucal. 2015 Nov 22;:0

Authors: Ferrés-Amat E, Pastor-Vera T, Ferrés-Amat E, Mareque-Bueno J, Prats-Armengol J, Ferrés-Padró E

Abstract
BACKGROUND: Partial ankyloglossia is a limitation which restricts the possibility of protrusion and elevation of the tip of the tongue due to the shortness of either the lingual frenulum or the genioglossus muscles or both. The principal objective of this paper is to present our protocol of action for the treatment of ankyloglossia. The specific objectives are to study patients with ankyloglossia treated by the Service of Maxillofacial Surgery and the Service of Speech Therapy of our pediatric Hospital, describe the diagnostic procedures, the pre-surgical intervention, the surgical technique undertaken and the post-surgical rehabilitation taking into account the level of collaboration of the patients, and finally, describe the surgical complications and the referral of patients.
MATERIAL AND METHODS: This is a descriptive study of healthy patients, without any diagnosis of syndrome, ranging between 4 and 14 years that have been surgically treated and rehabilitated post-surgery within a period of 2 years.
RESULTS: 101 frenectomies and lingual plasties have been performed and patients have been treated following the protocol of action that we hereby present. After the surgical intervention, the degree of ankyloglossia has been improved, considering correction in 29 (28%) of the patients (95% CI: 20%, 38%), reaching, with the post-surgical orofacial rehabilitation, a correction of 97 (96%) of the participants (95% CI: 90%, 98%).
CONCLUSIONS: The chosen surgical technique for moderate-severe ankyloglossia in our centre is the frenectomy and lingual plasty. The myofunctional training begins one week before the surgical intervention so that the patients learn the exercises without pain.

PMID: 26595832 [PubMed - as supplied by publisher]

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Association of susceptible genotypes to periodontal disease with the clinical outcome and tooth survival after non-surgical periodontal therapy: A systematic review and meta-analysis.

Association of susceptible genotypes to periodontal disease with the clinical outcome and tooth survival after non-surgical periodontal therapy: A systematic review and meta-analysis.

Med Oral Patol Oral Cir Bucal. 2015 Nov 22;:0

Authors: Chatzopoulos GS, Doufexi AE, Kalogirou F

Abstract
BACKGROUND: The real clinical utility of genetic testing is the prognostic value of genetic factors in the clinical outcome of periodontal treatment and the tooth survival. A meta-analysis was undertaken to estimate the effect of a susceptible genotype to periodontitis on the clinical outcomes of non-surgical periodontal therapy and the tooth survival.
MATERIAL AND METHODS: A systematic search of MEDLINE-Pubmed, Cochrane Library and Scopus was performed. Additionally, a hand search was done in three journals. No specific language restriction was applied. Two reviewers screened independently titles and abstracts or full text copies. Quality assessment of all the included studies was held.
RESULTS: Initial screening of electronic databases resulted in 283 articles. Ten studies met the inclusion criteria, nine of them examined the clinical outcome, while the other one investigated the tooth survival in susceptible individuals after non-surgical periodontal therapy. Eight of included studies were selected for the meta-analysis. IL-1 positive genotypes increase the risk of tooth loss, while no association found between the bleeding on probing (BOP), clinical attachment loss (CAL) and plaque index (PI) with the genotype status. Probing pocket depth (PPD) reduction in the first three months and in long-term results found to have a significant association with the genotype.
CONCLUSIONS: There is no difference in the clinical measurements after non-surgical periodontal treatment, apart from PPD. More publications are needed to identify a cause-effect relationship.

PMID: 26595831 [PubMed - as supplied by publisher]

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Expression of NF-κB and IL-6 in oral precancerous and cancerous lesions: An immunohistochemical study.

Expression of NF-κB and IL-6 in oral precancerous and cancerous lesions: An immunohistochemical study.

Med Oral Patol Oral Cir Bucal. 2015 Nov 22;:0

Authors: Kamperos G, Nikitakis N, Sfakianou A, Avgoustidis D, Sklavounou-Andrikopoulou A

Abstract
BACKGROUND: The purpose of this study was to evaluate the immunohistochemical expression of NF-κB and IL-6 in oral premalignant and malignant lesions and to investigate their possible correlation with the presence of subepithelial inflammation.
MATERIAL AND METHODS: Thirty two oral premalignant lesions, clinically compatible with leukoplakia or erythroplakia, were investigated. Microscopically, 11 of them showed hyperkeratosis and acanthosis (epithelial hyperplasia) and 21 showed dysplasia of varying degrees. Nine cases of OSCC and four control cases of normal oral mucosa were also included in the study. Immunohistochemical staining with NF-κB (p65) and IL-6 was performed. IL-6 and nuclear NF-κB staining were assessed as positive or negative. For cytoplasmic localization of NF-κB, a total score combining intensity and percentage of positive epithelial cells was additionally calculated. The presence of inflammation was also recorded.
RESULTS: Intensity and total scores for NF-κΒ cytoplasmic immunostaining showed a statistically significant gradual increase from normal mucosa to OSCC (p=0.012 and p=0.026 respectively). Non-statistically significant increased NF-κΒ nuclear localization was detected in dysplasias and OSCCs. Positive statistical correlation was detected between the presence of inflammation and IL-6 expression (p=0.015). No correlation between NF-κΒ and IL-6 was detected.
CONCLUSIONS: NF-κΒ is activated in the early stages of oral carcinogenesis. IL-6 may have an NF-κΒ-independent role, possibly through regulation of the inflammatory response.

PMID: 26595830 [PubMed - as supplied by publisher]

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Evaluation of Xerostomia and salivary flow rate in Hashimoto's Thyroiditis.

Evaluation of Xerostomia and salivary flow rate in Hashimoto's Thyroiditis.

Med Oral Patol Oral Cir Bucal. 2015 Nov 22;:0

Authors: Agha-Hosseini F, Shirzad N, Moosavi MS

Abstract
BACKGROUND: One of the most common causes of hypothyroidism is Hashimoto's Thyroiditis (HT). Early detection of dry mouth is critical in preserving and promoting systemic and oral health. In this study we have assessed, for the first time, salivary function and xerostomia in HT patients who have not been involved with Sjögren's syndrome.
MATERIAL AND METHODS: HT was diagnosed in 40 patients based on clinical findings and positive anti-thyroid peroxidase antibodies (anti-TPO). Controls, matched by sex, age and body mass index (BMI), and with no history of thyroid disease, were selected. A questionnaire was used for diagnosis of xerostomia. Saliva samples were taken between 8 a.m. and 9 a.m., and at least 2 hours after the last intake of food or drink. The flow rate was calculated in milliliters per minute.
RESULTS: Xerostomia was significantly higher in patients with HT. Unstimulated salivary flow rate was significantly lower in the HT group. Stimulated salivary flow rate was lower in HT group, but the difference was not significant.
CONCLUSIONS: The patients with HT experienced xerostomia, and their salivary flow rate was diminished. Spitting the saliva then assessing salivary flow rate based on milliliter per minute is non-invasive, fast, and simple for chair-side diagnosis of dry mouth. Autoimmune diseases can be accompanied by salivary gland dysfunction. This may be due to the effect of cytokines in the autoimmune process or because of thyroid hormone dysfunctions.

PMID: 26595829 [PubMed - as supplied by publisher]

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Relation between diagnosis of atheromatous plaque from orthopantomographs and cardiovascular risk factors. A study of cases and control subjects.

Relation between diagnosis of atheromatous plaque from orthopantomographs and cardiovascular risk factors. A study of cases and control subjects.

Med Oral Patol Oral Cir Bucal. 2015 Nov 22;:0

Authors: Barona-Dorado C, Gutierrez-Bonet C, Leco-Berrocal I, Fernández-Cáliz F, Martínez-González JM

Abstract
BACKGROUND: In recent years the use of orthopantomography has been proposed as a low-cost, reliable and non-invasive diagnostic medium for detecting atheromatous plaque. The purpose of this study was to correlate the presence of carotid calcifications (atheroma) in orthopantomographs with specific risk factors for cerebrovascular accidents (previous cerebrovascular accidents, arterial hypertension, and diabetes).
PATIENT AND METHODS: The methods used in this observational study of cases and control subjects followed STROBE (Strengthening the Reporting of Observational studies in Epidemiology) recommendations. The study analyzed a total of 1,602 panoramic radiographs taken for dental diagnostic purposes between January 2010 and February 2014. The main variables analyzed were the incidence of atheromatous plaque and other cardiovascular risk factors. Epidat 3.1 statistical software was used to determine minimum sample sizes and the results were analyzed using PASW (Predictive Analytics Software) Statistics 10.0.0.
RESULTS: For all the variables analyzed, the correlation between radiographic detection of atheromatous plaque and the presence of cardiovascular disease risk factors was found to be statistically significant (RR>1.5).
CONCLUSIONS: The presence of cardiovascular risk factors is related to the incidence of radiopaque lesions at the carotid artery bifurcation, indicating the presence of atheromatous plaque.

PMID: 26595828 [PubMed - as supplied by publisher]

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Long-term result of out-patient neodymium-doped yttrium aluminium garnet laser photocoagulation surgery for patients with epistaxis.

Long-term result of out-patient neodymium-doped yttrium aluminium garnet laser photocoagulation surgery for patients with epistaxis.

J Laryngol Otol. 2015 Nov 24;:1-6

Authors: Zhang J, Qiu R, Wei C

Abstract
OBJECTIVE: To evaluate the long-term efficacy of out-patient neodymium-doped yttrium aluminium garnet laser photocoagulation surgery for patients with epistaxis.
METHODS: A retrospective clinical study was conducted. A total of 217 consecutive patients who presented with acute or recurrent epistaxis received neodymium-doped yttrium aluminium garnet laser photocoagulation treatment in an out-patient setting.
RESULTS: At three years, 94 per cent of acute epistaxis patients versus 88 per cent of recurrent epistaxis patients reported no bleeding. The outcome scores at 12 weeks and 3 years after treatment showed no significant differences between the 2 groups (p = 0.207 and p = 0.186). However, there was a significant difference in outcome scores at four weeks after treatment (p = 0.034). The median (and mean ± standard deviation) pain levels experienced during the laser operation (performed in an office setting) were 4.0 (3.75 ± 2.09) in the acute epistaxis group and 4.0 (3.83 ± 2.01) in the recurrent epistaxis group. Neither group had any complications.
CONCLUSION: Neodymium-doped yttrium aluminium garnet laser photocoagulation is desirable in the treatment of both acute and recurrent epistaxis, and has long-lasting efficacy.

PMID: 26600379 [PubMed - as supplied by publisher]

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A study of mastoid pneumatisation and the presence of cholesteatoma in 393 patients.

A study of mastoid pneumatisation and the presence of cholesteatoma in 393 patients.

J Laryngol Otol. 2015 Nov 23;:1-3

Authors: Iqbal IZ, Watson C

Abstract
OBJECTIVES: This study aimed to evaluate the relationship between cholesteatoma formation and the degree of mastoid pneumatisation, and to assess the relationship between the location of cholesteatoma and the degree of mastoid pneumatisation.
METHODS: Data on all patients undergoing mastoid exploration for cholesteatoma between 1993 and 2011 were collected prospectively. Basic demographics, the degree of mastoid pneumatisation and cholesteatoma site were recorded.
RESULTS: A total of 393 patients (222 males and 171 females) underwent surgery for cholesteatoma. Patients' mean age was 37 years (range, 6-79 years). Pneumatisation of the mastoid was sclerotic in 23 per cent (n = 90), diploic in 16.7 per cent (n = 66) and cellular in 60.3 per cent of cases (n = 237) (p < 0.001). Atticoantral disease was present in 88.9 per cent of sclerotic, 95.4 per cent of diploic and 91.1 per cent of cellular mastoids. Middle-ear cholesteatoma was present in 54.4 per cent of sclerotic, 56 per cent of diploic and 51.9 per cent of cellular mastoids.
CONCLUSION: The findings demonstrate the presence of cholesteatoma in well-pneumatised mastoids. It is hypothesised that a well-pneumatised mastoid may lead to cholesteatoma formation.

PMID: 26592097 [PubMed - as supplied by publisher]

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[ANESTHESIA FOR AIRWAY ENDOSCOPIC RECANALISATION WITH SELFEXPANDED STENTS].

[ANESTHESIA FOR AIRWAY ENDOSCOPIC RECANALISATION WITH SELFEXPANDED STENTS].

Anesteziol Reanimatol. 2015 Jul-Aug;60(4):11-9

Authors: Khasanov AF, Trifonov VR, Murav'ov VY, Khasanova NA, Ivanov AI, Ivanovskaya KA

Abstract
UNLABELLED: Tracheal and bronchial endoscopic stenting can give a quick therapeutic result or delay surgiCal treatment of patients with stenosis. It also can improve quality of life, create conditions for palliative therapy and increase survival of incur- able oncological patients. This paper contains description of our experience in anesthesia for tracheal stenting with re- spiratory support.
MATERIALS AND METHODS: 23 patients were investigated retrospectively (15 males, 8females). They had 28 interventions under general anesthesia. 14 patients had malignant and 9 had non-malignant lesions. Complicated somatic status, stenosis extention and localization, type of laryngoscope. unprotected airways determined choice of in- travenous anesthesia with high-frequency ventilation and muscle relaxation.
RESULTS: Improvement (dyspnea decreasing) was mentioned in 78,3% (18/23) cases after stenting, in 8,7% (2/23) cases improvement was slight; in 4,3% (1/23) cases - no change; in 8,7% (2/23) cases patients died complications after stenting occurred in 10 cases (43,5%). In 4 cases (17,4%) - stent displacement; in 2 cases (8,7%) - purulent tracheobronchitis; in 1 case (4,35%) - paroxysmal cough with pain. In 1 case loss of stent during paroxysmal cough and vocal cords edema occurred. In 2 cases (8,7%) operation was failed and patients died due to the lesion progression and respiratory insufficiency.
CONCLUSIONS: Anesthetic pro- tection is an important component at endoscopic recanalization with selfexpanded stents. Management is difficult due to complicated somatic status, and unprotected airways. Significant health enhancement, dyspnea decreasing even by exercise stress justified high anesthetics risks.

PMID: 26596025 [PubMed - in process]

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Early phonetic development in typically developing children: A longitudinal investigation from Cypriot-Greek child data.

Early phonetic development in typically developing children: A longitudinal investigation from Cypriot-Greek child data.

Clin Linguist Phon. 2015 Nov 23;:1-17

Authors: Petinou K, Theodorou E

Abstract
The current longitudinal study examined the acquisition of consonantal singleton segments in Cypriot-Greek. The study's aims were: (a) to determine the acquisition of segments for manner and place of articulation as a function of age and word position, (b) to provide preliminary normative data, and (c) to further support the cross-linguistic data pool regarding developmental phonology patterns. Participants were 14 Cypriot-Greek speaking typically developing toddlers, examined at ages 24, 28, 32 and 36 months. Spontaneously produced and elicited glossable utterances were used in constructing each child's inventory. Findings revealed an increase of segmental acquisition across all age levels. Group trend analysis for manner and place of articulation indicated bilabial and alveolar stops and nasals to be among the earlier segments to develop. A word medial position advantage was also evident. The findings are discussed in terms of phonological universals and language-specific factors. Implications for early evidence-based phonetic assessment are discussed.

PMID: 26597650 [PubMed - as supplied by publisher]

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Editorial Board EOV.

Editorial Board EOV.

Clin Linguist Phon. 2015 Dec;29(12):ebi

Authors:

PMID: 26596329 [PubMed - in process]

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How fluent is the fluent speech of people who stutter? A new approach to measuring kinematics with ultrasound.

How fluent is the fluent speech of people who stutter? A new approach to measuring kinematics with ultrasound.

Clin Linguist Phon. 2015 Nov 23;:1-21

Authors: Heyde CJ, Scobbie JM, Lickley R, Drake EK

Abstract
We present a new approach to the investigation of dynamic ultrasound tongue imaging (UTI) data, applied here to analyse the subtle aspects of the fluency of people who stutter (PWS). Fluent productions of CV syllables (C = /k/; V = /ɑ, i, ə/) from three PWS and three control speakers (PNS) were analysed for duration and peak velocity relative to articulatory movement towards (onset) and away from (offset) the consonantal closure. The objective was to apply a replicable methodology for kinematic investigation to speech of PWS in order to test Wingate's Fault-Line hypothesis. As was hypothesised, results show comparable onset behaviours for both groups. Regarding offsets, groups differ in peak velocity. Results suggest that PWS do not struggle initiating consonantal closure (onset). In transition from consonantal closure into the vowel, however, groups appear to employ different strategies expressed in increased variation (PNS) versus decreased mean peak velocity (PWS).

PMID: 26596188 [PubMed - as supplied by publisher]

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The effect of speaking context on spectral- and cepstral-based acoustic features of normal voice.

The effect of speaking context on spectral- and cepstral-based acoustic features of normal voice.

Clin Linguist Phon. 2015 Nov 23;:1-11

Authors: Lowell SY, Hylkema JA

Abstract
The effect of speaking context on four cepstral- and spectral-based acoustic measures was investigated in 20 participants with normal voice. Speakers produced three different continuous speaking tasks that varied in duration and phonemic content. Cepstral and spectral measures that can be validly derived from continuous speech were computed across the three speaking contexts. Cepstral peak prominence (CPP), low/high spectral ratio, and the standard deviation (SD) of the low/high spectral ratio did not significantly differ across speaking contexts, and correlations for the first two measures were strong among the three speaking tasks. The SD of the CPP showed significant task differences, and relationships between the speaking contexts were generally moderate. These findings suggest that in speakers with normal voice, the differing phonemic content across several frequently used speaking stimuli minimally impacted group means for three clinically relevant cepstral- and spectral-based acoustic measures.

PMID: 26595764 [PubMed - as supplied by publisher]

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Bilateral posterior fracture-dislocation of the shoulders following epileptic seizures: a case report and review of the literature.

Bilateral posterior fracture-dislocation of the shoulders following epileptic seizures: a case report and review of the literature.

BMC Res Notes. 2015;8(1):704

Authors: Pushpakumara J, Sivathiran S, Roshan L, Gunatilake S

Abstract
BACKGROUND: Bilateral posterior fracture-dislocation of the shoulders is an uncommon complication of grand mal seizures. We report a case of bilateral posterior dislocation of the shoulders with proximal humeral fractures following epileptic seizures. A posterior fracture-dislocation of the shoulder is very rare and can be caused by epileptic seizures, trauma, electrocution or electroconvulsive therapy.
CASE PRESENTATION: A 62-year-old Sri Lankan male was admitted to our medical unit following four repeated generalized tonic-clonic convulsions, each lasting for several minutes. Following the second seizure he reported an inability to move both upper arms due to intense pain. There was no history of fall during the episodes of convulsions however but the bystanders have forcibly restrained his movements during the tonic-clonic convulsions. Clinical examination revealed severely restricted range of movement in both shoulders, with associated swelling and bruising of the shoulder joints and upper arms. Radiographs of the shoulders confirmed fractures at the level of surgical neck with posterior dislocation.
CONCLUSION: Bilateral posterior fracture-dislocation of shoulders complicating epileptic seizures are rare. Forcible restraining of the patient's upper limbs during seizures is the likely cause for the fracture dislocations in our patient and this had not been reported before.

PMID: 26597040 [PubMed - in process]

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[Bradykinin-induced angioedema : Definition, pathogenesis, clinical presentation, diagnosis and therapy].

[Bradykinin-induced angioedema : Definition, pathogenesis, clinical presentation, diagnosis and therapy].

HNO. 2015 Nov 23;

Authors: Hahn J, Bas M, Hoffmann TK, Greve J

Abstract
The incidence of bradykinin-induced angioedema is considerably lower than that of histamine-induced forms; however, the same is true for the clinician's knowledge of this condition. Bradykinin-induced angioedemas include hereditary angioedema (HAE), as well as acquired forms induced by drugs or antibody formation, e.g., during the course of oncologic disease. Drug-induced forms affect almost exclusively the head and neck region, and are thus important for the otorhinolaryngologist. Clear differentiation between histamine-induced angioedema (e. g., connected to allergy/urticaria) and bradykinin-induced angioedema is essential for selection of the specific treatment and may be lifesaving. Antihistamines and cortisone derivatives have no relevant effect in bradykinin induced-angioedema, whereas blood-derived C1 esterase inhibitor and bradykinin receptor 2 antagonists represent effective therapeutic options-both for acute and prophylactic treatment.

PMID: 26597136 [PubMed - as supplied by publisher]

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[Hygiene in otorhinolaryngology : Requirements and reality].

[Hygiene in otorhinolaryngology : Requirements and reality].

HNO. 2015 Nov 23;

Authors: Jager E, Heudorf U

Abstract
Considering the physiological contamination of skin and mucous membranes in the ear, nose, and throat region by facultative pathogen microorganisms, as well as the increase in multidrug resistant organisms (MDRO), it is mandatory that hygienic procedures be observed in ENT institutions, in order to prevent transmission of bacteria and infections in patients. General guidelines for hygiene in otorhinolaryngology are presented based on the recommendations published by the German Commission on Hospital Hygiene and Infection Prevention (KRINKO). These encompass hand hygiene, surface disinfection, and reprocessing of medical devices. The correct reprocessing of the various components of ENT treatment units (including endoscopes, water bearing systems) is reported. Although law requires and KRINKO recommends that manufacturers of medical devices publish instructions for reprocessing their products, these reprocessing recommendations are often insufficient. Manufacturers should thus be called upon to improve their recommendations. In this paper, the requirements for handling of ENT treatment units are compared with the observations made by the Public Health Department in 7 ENT clinics and 32 ENT practices in Frankfurt/Main, Germany, in 2014.

PMID: 26597135 [PubMed - as supplied by publisher]

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[Medical examination: Preparation for ENT specialisation : Part 22].

[Medical examination: Preparation for ENT specialisation : Part 22].

HNO. 2015 Nov 23;

Authors: Zenk J, Psychogios G

PMID: 26597134 [PubMed - as supplied by publisher]

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Quality of Life Outcomes Following Resection of Adult Intramedullary Spinal Cord Tumors.

Quality of Life Outcomes Following Resection of Adult Intramedullary Spinal Cord Tumors.

Neurosurgery. 2015 Nov 20;

Authors: Xiao R, Miller JA, Abdullah KG, Lubelski D, Mroz TE, Benzel EC

Abstract
BACKGROUND: Intramedullary spinal cord tumors are rare but clinically significant entities. Resection is critical to prevent permanent neurological deficits. However, no studies have investigated the quality of life (QOL) benefit of resection in adults.
OBJECTIVE: To investigate QOL outcomes after intramedullary spinal cord tumors resection.
METHODS: A consecutive retrospective review of all patients who underwent intramedullary spinal cord tumors resection at a single tertiary care institution between January 2008 and December 2013 was conducted. QOL was measured by the EuroQol 5-Dimensions (EQ-5D), Pain Disability Questionnaire (PDQ), and Patient Health Questionnaire-9. Multivariable regression was used to identify independent predictors of outcomes.
RESULTS: Among 45 patients, the most common pathology was ependymoma (60%). No significant changes between preoperative and postoperative EQ-5D, PDQ, or Patient Health Questionnaire-9 were observed. Improvements exceeding the minimal clinically important difference occurred in 28% of patients in EQ-5D, 28% in PDQ, and 16% in Patient Health Questionnaire-9. Worse preoperative neurological status predicted worsened EQ-5D (β = -0.09, P = .04) and PDQ (β = 20.77, P < .01), while ependymomas predicted QOL improvement exceeding the minimal clinically important difference in PDQ (OR 14.98, P = .04) and approached significance in EQ-5D (OR 43.52, P = .06). Conversely, cervical tumors predicted worsened PDQ (β = 18.32, P < .01) and failure to achieve EQ-5D minimal clinically important difference (OR <0.01, 95% CI <0.01-0.65, P = .02). Postoperative complications, such as syrinx formation (β = -0.09, P = .04) and cerebrospinal fluid leak (β = 13.85, P = .04), predicted diminished improvement in EQ-5D and PDQ, respectively.
CONCLUSION: Although resection did not significantly improve QOL, it is likely necessary to arrest QOL deterioration. Patients with better preoperative neurological status or ependymoma experienced QOL improvement, while postoperative complications negatively impacted long-term QOL.
ABBREVIATIONS: EQ-5D, EuroQol 5-DimensionsGTR, gross total resectionIMSCT, intramedullary spinal cord tumorsMCID, minimal clinically important differenceMMS, Modified McCormick ScalePDQ, Pain Disability QuestionnairePHQ-9, Patient Health Questionnaire-9POD, plane of dissectionQOL, quality of lifeSSI, surgical site infection.

PMID: 26600282 [PubMed - as supplied by publisher]

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Hypopharyngeal squamous cell carcinoma: Three-dimensional or Intensity-modulated radiotherapy? A single institution's experience.

Hypopharyngeal squamous cell carcinoma: Three-dimensional or Intensity-modulated radiotherapy? A single institution's experience.

Laryngoscope. 2015 Nov 24;

Authors: Katsoulakis E, Riaz N, Hu M, Morris L, Sherman E, McBride S, Lee N

Abstract
OBJECTIVES/HYPOTHESIS: Compare outcomes of hypopharyngeal carcinoma that received conventional radiotherapy versus intensity-modulated radiotherapy (IMRT).
STUDY DESIGN: Retrospective single-institution trial.
METHODS: Between April 1990 and May 2011, 100 patients with hypopharyngeal cancer underwent curative radiotherapy (RT) at our institution: 50 with IMRT and 50 with conventional RT. The median age was 63 years. There were 12 T1, 22 T2, 37 T3, and 28 T4 patients. The majority of patients (82%) had nodal disease: 54% N2 and 8% N3. The majority of patients (83%) received chemotherapy. Of the patients who received chemotherapy, 84% received a platinum-based regimen. The median RT dose was 7,000 cGy. The majority of patients (62%) had prophylactic percutaneous endoscopic gastrostomy tube placement. Toxicities were reviewed. Local control (LC), locoregional control (LRC), freedom from distant metastasis (FFM) rates, functional larynx preservation (LP), laryngectomy-free survival (LFS), and overall-survival (OS) curves were generated using the Kaplan-Meier method. The log-rank test was used to test prognostic variables.
RESULTS: With a median follow up of 48.4 months, the 3/5-year LC, LRC, FFM, LP, LFS and OS rates were 74%/69%, 77%/74%, 70%/66%, 51%/29%, 49.6%/31.8%, and 49%/34%, respectively. The median OS was 2.9 years. The 3-year LC rate for IMRT was 77% versus 81% for conventional RT (P = .91); 3-year LRC for IMRT was 85% versus 76% for conventional RT (P = .32). There was no increased local failure with IMRT. There was no difference in the rate of stricture with IMRT (32%) versus conventional RT (25.3%) (P = .86).
CONCLUSIONS: IMRT achieved comparable LC and LRC rates to conventional RT.
LEVEL OF EVIDENCE: 4 Laryngoscope, 2015.

PMID: 26597398 [PubMed - as supplied by publisher]

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Subjective and objective voice outcomes after transoral laser microsurgery for early glottic cancer.

Subjective and objective voice outcomes after transoral laser microsurgery for early glottic cancer.

Laryngoscope. 2015 Nov 24;

Authors: Fink DS, Sibley H, Kunduk M, Schexnaildre M, Kakade A, Sutton C, McWhorter AJ

Abstract
OBJECTIVES/HYPOTHESIS: Transoral laser microsurgery (TLM) continues to gain popularity as a treatment modality for early glottic cancer. Oncologic outcomes have been well-defined, but there are little data to date describing functional outcomes accounting for stage of resection.
STUDY DESIGN: Retrospective review.
METHODS: We retrospectively reviewed patient-rated voice handicap and observer-rated vocal quality of patients who underwent TLM for early glottic carcinoma. Patients were grouped by European Laryngological Society (ELS) resection type, and the data were combined for ELS type I-III and compared with advanced resections (ELS IV-VI). The Voice Handicap Index (VHI) was used for patient-rated voice outcomes, and voice recordings were graded by two senior speech-language pathologists. Voice recordings and VHI scores were taken preoperatively and at least 1 month postoperatively.
RESULTS: No major complications were encountered. Six of 49 patients underwent repeat resection for suspicious findings with pathology, demonstrating moderate dysplasia in two cases, carcinoma in situ in two cases, and inflamed mucosa only in two cases. There was no significant difference in preoperative VHI scores or objective voice grades among patients who underwent limited (ELS I-III) and those who required more advanced (ELS IV-VI) resection. There was a significant improvement in VHI scores in patients after ELS type I to III resection, from 38.77 to 22.86 (P = .006). There was no significant difference between mean preoperative and postoperative perceptual evaluation scores in patients who underwent ELS type I, II, or III resections (62.25 and 64.32 respectively, P = .621).
CONCLUSIONS: Patients who undergo limited ELS resections can be assured of having a similar to improved voice after healing. Patients who undergo extended resections have poorer vocal outcomes.
LEVEL OF EVIDENCE: 4 Laryngoscope, 2015.

PMID: 26597360 [PubMed - as supplied by publisher]

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The treatment of pharyngoesophageal perforation following anterior cervical spine intervention.

The treatment of pharyngoesophageal perforation following anterior cervical spine intervention.

Auris Nasus Larynx. 2015 Nov 16;

Authors: Aslıer M, Doğan E, Ecevit MC, Erdağ TK, Ikiz AO

Abstract
OBJECTIVE: We aimed to investigate the diagnostic and therapeutic approaches in pharyngoesophageal perforation (PEP) following anterior cervical spine intervention (ACSI).
METHODS: We reviewed the records of four patients with PEP after ACSI. Symptoms, physical examination findings, imaging results, treatment, and follow-up characteristics were evaluated.
RESULTS: All four patients had undergone ACSI for either cervical trauma or cervical disc herniation with cervical cage reconstruction. Symptoms developed within the first 10 days of the postoperative period in three patients, and in the eighth month in one patient. Mucosal defects were detected during neck exploration in three patients. Reconstruction with primary suture and a local muscle flap was utilized in two patients. Three patients were discharged 3-8 weeks after surgical treatment.
CONCLUSION: In cases of PEP after ACSI, a good prognosis can be achieved when symptoms are detected in the early period and reconstruction with local muscle flap is applied.

PMID: 26597346 [PubMed - as supplied by publisher]

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Plasticity of the human vestibulo-ocular reflex during off-vertical axis rotation.

Plasticity of the human vestibulo-ocular reflex during off-vertical axis rotation.

Auris Nasus Larynx. 2015 Nov 17;

Authors: Akutsu M, Sugita-Kitajima A, Mikami K, Koizuka I

Abstract
OBJECTIVE: We investigated whether adaptive plasticity of the vestibulo-ocular reflex in humans occurs in response to visual-vestibular conflict stimulation during rotation about a 30° incline (off-vertical earth axis rotation, OVAR).
METHODS: Subjects were 26 healthy adults (17 males and 9 females), ranging in age from 22 to 33 years (mean: 24.4) with no history of neurotological symptoms. Each testing session consisted of a pre-test, an adaptation period, and a post-test. The pre-test and the post-test were performed in complete darkness with the subjects' eyes opened. Subjects were rotated sinusoidally at 0.16Hz under OVAR, with a maximum angular velocity of 60°/s for 30s. Subjects were divided into two groups depending on the kind of visual stimulation. One group of subjects was rotated sinusoidally at 0.16Hz and 60°/s peak velocity under OVAR for 20min while viewing optokinetic stripes, which moved at the same frequency and peak velocity as the rotational chair but in the opposite direction (X2 adaptation paradigm). The other group of subjects was rotated sinusoidally at 0.16Hz and 60°/s peak velocity under OVAR for 20min while viewing optokinetic stripes, which moved at the same frequency and peak velocity as the rotatory chair but in the same direction (X0 adaptation paradigm).
RESULTS: There was no significant difference in gain before or after adaptation using the X2 adaptation paradigm. VOR gain decreased significantly after adaptation using the X0 adaptation paradigm.
CONCLUSION: We hypothesize that attenuation of VOR gain increase after the X2 adaptation paradigm is caused by tilt suppression. In the X0 adaptation paradigm, the decrease in VOR gain was facilitated by tilt suppression in addition to the plastic change of the VOR gain caused by visual-vestibular conflict stimulation. Consequently, the VOR gain change ratio in the X0 adaptation paradigm increased significantly compared to that in the X2 adaptation paradigm.

PMID: 26597305 [PubMed - as supplied by publisher]

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Subject-Specific Computational Modeling of Evoked Rabbit Phonation.

Subject-Specific Computational Modeling of Evoked Rabbit Phonation.

J Biomech Eng. 2015 Nov 23;

Authors: Chang S, Novaleski CK, Kojima T, Mizuta M, Luo H, Rousseau B

Abstract
When developing high-fidelity computational model of vocal fold vibration for voice production of individuals, one would run into typical issues of unknown model parameters and model validation of individual-specific characteristics of phonation. In the current study, the evoked rabbit phonation is adopted to explore some of these issues. In particular, the mechanical properties of the rabbit's vocal fold tissue are unknown for individual subjects. In the model, we couple a 3D vocal fold model that is based on the MR scan of the rabbit larynx and a simple 1D model for the glottal airflow to perform fast simulations of the vocal fold dynamics. This hybrid 3D/1D model is then used along with the experiment measurement of each individual subject for determination of the vocal fold properties. The vibration frequency and deformation amplitude from the final model are matched reasonably well for individual subjects. The modeling and validation approaches adopted here could be useful for future development of subject-specific computational models of vocal fold vibration.

PMID: 26592748 [PubMed - as supplied by publisher]

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Evolutionary Trade-Off between Vocal Tract and Testes Dimensions in Howler Monkeys.

Evolutionary Trade-Off between Vocal Tract and Testes Dimensions in Howler Monkeys.

Curr Biol. 2015 Nov 2;25(21):2839-44

Authors: Dunn JC, Halenar LB, Davies TG, Cristobal-Azkarate J, Reby D, Sykes D, Dengg S, Fitch WT, Knapp LA

Abstract
Males often face a trade-off between investments in precopulatory and postcopulatory traits [1], particularly when male-male contest competition determines access to mates [2]. To date, studies of precopulatory strategies have largely focused on visual ornaments (e.g., coloration) or weapon morphology (e.g., antlers, horns, and canines). However, vocalizations can also play an important role in both male competition and female choice [3-5]. We investigated variation in vocal tract dimensions among male howler monkeys (Alouatta spp.), which produce loud roars using a highly specialized and greatly enlarged hyoid bone and larynx [6]. We examined the relative male investment in hyoids and testes among howler monkey species in relation to the level of male-male competition and analyzed the acoustic consequences of variation in hyoid morphology. Species characterized by single-male groups have large hyoids and small testes, suggesting high levels of vocally mediated competition. Larger hyoids lower formant frequencies, probably increasing the acoustic impression of male body size and playing a role analogous to investment in large body size or weaponry. Across species, as the number of males per group increases, testes volume also increases, indicating higher levels of postcopulatory sperm competition, while hyoid volume decreases. These results provide the first evidence of an evolutionary trade-off between investment in precopulatory vocal characteristics and postcopulatory sperm production.

PMID: 26592343 [PubMed - in process]

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Comparison the results of two different vestibular system surgery in patients with persistent Meniere's disease.

Comparison the results of two different vestibular system surgery in patients with persistent Meniere's disease.

Adv Biomed Res. 2015;4:198

Authors: Soheilipour S, Abtahi SH, Soltani M, Khodadadi HA

Abstract
BACKGROUND: Incidence rates of Meniere's disease vary considerably from 157/100,000 in the United Kingdom to 15/100,000 in the United States. Furthermore, in Iran prevalence of Meniere's disease is high, whereas we have not a reliable statistical study on it. A wide range of treatments are used for the treatment of the condition with no consensus on the most effective intervention. The aim of the present study, which involved 37 patients treated because of severe vertigo due to persistent Meniere's disease from 1996 to 2011, was to compare the effectiveness of two surgical methods cochleosacculotomy and endolymphatic sac decompression on vertigo and tinnitus.
MATERIALS AND METHODS: In a cross-sectional study, we compared two surgical approaches in patients with Meniere's disease who did not respond to usual medical treatment. Twenty-three patients underwent cochleosacculotomy surgery and 14 patients endolymphatic sac decompression surgery. We compared all the patients for resolving of vertigo, tinnitus.
RESULTS: After surgery, in patients of both group vertigo was improved significantly (P < 0.0001), tinnitus was improved, but it was not significant (P > 0.05) and hearing level was worse than before (especially in patients who had undergone cochleosacculotomy) (P < 0.0001).
CONCLUSION: Based on the data of the current study, cochleosacculotomy and endolymphatic sac decompression improved vertigo in patients with persistent Meniere's disease.

PMID: 26601086 [PubMed - as supplied by publisher]

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The use of Nerve Monitoring in the Placement of Vagal Nerve Stimulators.

The use of Nerve Monitoring in the Placement of Vagal Nerve Stimulators.

Clin Otolaryngol. 2015 Nov 24;

Authors: Townsley RB, Hilmi OJ

Abstract
Vagal nerve stimulators are approved by the National Institute for Health and Care Excellence in the treatment of epilepsy(1) and depression(2) refractory to medical therapies. Experimentally, their use is being explored in stroke rehabilitation, the treatment of tinnitus, intractable headache and vomiting disorders.(3) This article is protected by copyright. All rights reserved.

PMID: 26597336 [PubMed - as supplied by publisher]

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[Character of early tinnitus about sudden deafness].

[Character of early tinnitus about sudden deafness].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 May;29(10):909-11

Authors: Wang R, Guo M, Miao Y

Abstract
OBJECTIVE: To study the clinical characteristics of early tinnitus in patients with sudden deafness.
METHOD: Forty-seven patients with sudden deafness and early tinnitus recieved subjective review and filled out classified questionnaire of tinnitus. By pure tone audiometry and tinnitus matching test, we obtain the distribution, quantity and matching loudness of tinnitus patients.
RESULT: (1) Objective examination: the most common frequencies of tinnitus were 8000 Hz and 4000 Hz. The most common numbers were two frequencies. The matching loudness was (16.63 ± 8.37) dB. (2) Subjective examination: the tinnitus was monotone (74.0%), sustained (89.0%), third level loudness (45.0%), third level annoying (60.0%), high frequency (83.0%), sound of cicadas (66.7%). The most influencing factors were hearing (28.2%) and mood (29.5%). (3) Relationship between tinnitus and pure tone hearing threshold curve: there was a significant correlation between the frequency of pure tone audiometry and the matching loudness of tinnitus (r = -0. 370, P < 0.01). There was no significant correlation between the frequency of pure tone tinnitus and the matching loudness of tinnitus (r = -0.083, P > 0.05).
CONCLUSION: (1) The results of subjective examination were consistent with those of objective examination. (2) The tinnitus should be considered in the early treatment of sudden deafness.

PMID: 26596006 [PubMed - in process]

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[Clinical characteristics of tinnitus complaint: an analysis of 453 patients].

[Clinical characteristics of tinnitus complaint: an analysis of 453 patients].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 May;29(10):889-92

Authors: Liu Z, Liang Y, Sun P, Yang C, Liu Y, Li Y, Han X, He P, Zeng L

Abstract
OBJECTIVE: To evaluate the clinical characteristics of tinnitus complaint.
METHOD: The information of 628 patients with subjective tinnitus was collected using questionnaires from October, 2013 to June, 2014. Among them, 453 cases were included in this study, whose quality of life and sleep were significantly affected. Then we elucidated the features of tinnitus, tinnitus incentives and systemic diseases and analyzed their relationship.
RESULT: The proportion of the patients complaint was highest in gruop ≤ 30 y. The patients with tinnitus complaint were more likely to have persistent tinnitus with higher loudness VAS scores than their counterparts. 65.4% of the total patients had at least one treatment (52.2% of patients can tolerate, and only 13. 2% can not tolerate). More patients had cranial Ming on the left than on the right ear. The proportion of patients with polyphony in bilateral tinnitus was higher than those with unilateral tinnitus (P < 0.05). Moreover, 59% patients had tinnitus inducing factors, and 44% patients had systemic comorbidities (The three most frequently involved systems were otolaryngologic, cardiovascular and digestive system). There was no significantly statistical difference of the tinnitus severity between patients with other systematic diseases and those without.
CONCLUSION: Patients with tinnitus complaint were younger in age (≤ 30 y) and more likely to have persistent tinnitus with higher loudness VAS scores Predisposing factors are closely associated with mental or physical trauma. The accompanied diseases can be classified by organ system.

PMID: 26596001 [PubMed - in process]

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Auditory perception of non-sense and familiar Bengali rhyming words in children with and without SLD.

Auditory perception of non-sense and familiar Bengali rhyming words in children with and without SLD.

Int J Pediatr Otorhinolaryngol. 2015 Nov 10;

Authors: Sinha A, Rout N

Abstract
BACKGROUND: Rhyming ability is among the earliest metaphonological skills to be acquired during the process of speech and language acquisition. Metalinguistic skills, particularly metaphonological skills, greatly influence language learning during early, school grades and reportedly children with learning disorders are poor at these skills.
AIM AND OBJECTIVES: To develop and validate a Bengali rhyming checklist and study the auditory perception of non-sense and familiar Bengali rhyming words in children with and without specific learning disability (SLD).
METHOD: 60 children, age range 8-11years, participated in two groups; group-A included children with SLD and group-B, typically developing children (TDC). All participants were native Bengali speakers, attending regular school, with hearing sensitivity less than 25dBHL, no history of ear discharge and middle socioeconomic background. A rhyming checklist was developed in Bengali, consisting of familiar (section-A) and non-sense (section-B) words. Test-retest reliability and validity measures were obtained. The items on the checklist were audio recorded and presented to the participants in a rhyming judgment task in one to one set up. Scores were obtained and statistically analyzed using SPSS software (version-11.0).
RESULT: Children with SLD scored significantly low on the rhyming judgment task as against TDC (p<.05) for both familiar and non-sense words. Children with SLD performed significantly better on familiar word rhyming judgment task against non-sense words (p<.05). TDC showed no significant difference on familiar and non-sense words rhyming judgment tasks (p>.05).
CONCLUSION: Semantic content influences rhyming perception in children with SLD but has no significant effect on TDC. The developed rhyming checklist may be used as a screening tool for children at risk of SLD at primary school grades. Rhyming activities may be utilized by teachers and parents, to promote language learning in young learners.

PMID: 26596687 [PubMed - as supplied by publisher]

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The "multiport airway adapter" in flexible bronchoscopy for peripheral bronchial foreign bodies in children.

The "multiport airway adapter" in flexible bronchoscopy for peripheral bronchial foreign bodies in children.

Int J Pediatr Otorhinolaryngol. 2015 Nov 9;

Authors: Matsushita K, Uchida K, Otake K, Nagano Y, Koike Y, Inoue M, Kusunoki M

Abstract
Many children require emergency foreign body removal by bronchoscopy. Although a flexible bronchoscope is frequently used for removal of a bronchial foreign body in children, this procedure is difficult in children with a narrow tracheal lumen, even using a thin flexible bronchoscope. This report describes the use of a multiport airway adaptor to remove a bronchial foreign body with a flexible bronchoscope. The thicker forceps etc. were passed alongside the flexible bronchoscope through the adaptor. These findings suggest that this multiport airway adaptor will be useful as an advanced tool for foreign body removal in pediatric patients.

PMID: 26596686 [PubMed - as supplied by publisher]

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Radiation dose reduction in postoperative computed position control of cochlear implant electrodes in lambs - An experimental study.

Radiation dose reduction in postoperative computed position control of cochlear implant electrodes in lambs - An experimental study.

Int J Pediatr Otorhinolaryngol. 2015 Nov 4;

Authors: Weisstanner C, Mantokoudis G, Huth M, Verma RK, Nauer C, Senn P, Caversaccio MD, Wagner F

Abstract
OBJECTIVE: Cochlear implants (CI) are standard treatment for prelingually deafened children and postlingually deafened adults. Computed tomography (CT) is the standard method for postoperative imaging of the electrode position. CT scans accurately reflect electrode depth and position, which is essential prior to use. However, routine CT examinations expose patients to radiation, which is especially problematic in children. We examined whether new CT protocols could reduce radiation doses while preserving diagnostic accuracy.
METHODS: To investigate whether electrode position can be assessed by low-dose CT protocols, a cadaveric lamb model was used because the inner ear morphology is similar to humans. The scans were performed at various volumetric CT dose-indexes CTDIvol)/kV combinations. For each constant CTDIvol the tube voltage was varied (i.e., 80, 100, 120 and 140kV). This procedure was repeated at different CTDIvol values (21mGy, 11mGy, 5.5mGy, 2.8mGy and 1.8mGy). To keep the CTDIvol constant at different tube voltages, the tube current values were adjusted. Independent evaluations of the images were performed by two experienced and blinded neuroradiologists. The criteria diagnostic usefulness, image quality and artifacts (scaled 1-4) were assessed in 14 cochlear-implanted cadaveric lamb heads with variable tube voltages.
RESULTS: Results showed that the standard CT dose could be substantially reduced without sacrificing diagnostic accuracy of electrode position. The assessment of the CI electrode position was feasible in almost all cases up to a CTDIvol of 2-3mGy. The number of artifacts did not increase for images within this dose range as compared to higher dosages. The extent of the artifacts caused by the implanted metal-containing CI electrode does not depend on the radiation dose and is not perceptibly influenced by changes in the tube voltage. Summarizing the evaluation of the CI electrode position is possible even at a very low radiation dose.
CONCLUSIONS: CT imaging of the temporal bone for postoperative electrode position control of the CI is possible with a very low and significantly radiation dose. The tube current-time product and voltage can be reduced by 50% without increasing artifacts. Low-dose postoperative CT scans are sufficient for localizing the CI electrode.

PMID: 26596357 [PubMed - as supplied by publisher]

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Risk factors for granuloma formation in children induced by tracheobronchial foreign bodies.

Risk factors for granuloma formation in children induced by tracheobronchial foreign bodies.

Int J Pediatr Otorhinolaryngol. 2015 Nov 4;

Authors: Huang Z, Zhou A, Zhang J, Xie L, Li Q

Abstract
OBJECTIVE: The aim of this study was to analyze the risk factors for granuloma formation caused by plant-based tracheobronchial foreign bodies in children, and investigate the underlying pathogenesis.
METHOD: In this retrospective analysis of 153 cases with tracheobronchial foreign bodies (peanuts and watermelon seeds), 35 cases of granuloma formation as granulation group (G), and 118 cases of no granuloma formation as non-granulation group (NG) were studied. Clinical data pertaining to sex (S), age (A), foreign body surface smoothness (SF), foreign body shape (SH), foreign body oil release state (O), the location of foreign bodies (L), and foreign body retention time (T) were collected for statistical analysis.
RESULTS: Univariate analysis showed no significant difference between the two groups (G and NG) with respect to S, A, SH and L. Significant factors based on univariate analysis included SF, O and T. Multivariate logistic regression analysis revealed that SF and T were independent risk factors associated with development of granuloma.
CONCLUSIONS: SF, O and T had relationship with the granuloma formation. Local trauma caused by an irregular and sharp foreign body, and extended period of time represent the main factors causing granuloma formation.

PMID: 26596356 [PubMed - as supplied by publisher]

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Treatment Effectiveness for Symptoms of Patulous Eustachian Tube: A Systematic Review.

Treatment Effectiveness for Symptoms of Patulous Eustachian Tube: A Systematic Review.

Otol Neurotol. 2015 Dec;36(10):1593-600

Authors: Luu K, Remillard A, Fandino M, Saxby A, Westerberg BD

Abstract
OBJECTIVES: To determine the effectiveness of currently available medical and surgical interventions for treating symptoms of Patulous Eustachian Tube (PET).
DATA SOURCES: A comprehensive search of MEDLINE (January 1948 to July 8, 2015), EMBASE (January 1974 to July 8, 2015), gray literature, hand searches, and cross-reference checking.
STUDY SELECTION: Original published reports evaluating an intervention to treat the symptoms of patulous eustachian tube in patients 18 years and older.
DATA EXTRACTION: Quality-of-case reviews were assessed with the National Institute of Health (NIH) Quality Assessment Tool for Case Series Studies.
DATA SYNTHESIS: The search strategy identified 1,104 unique titles; 39 articles with 533 patients are included. The available evidence consists of small case series and case reports. The most common medical treatment was nasal instillation of normal saline. Surgical treatments were categorized as mass loading of the tympanic membrane, eustachian tube plugging, and manipulation of eustachian tube musculature.
CONCLUSIONS: The available evidence for management of patients with PET is poor in quality and consists predominantly of small case series. Further research is needed to determine the comparative efficacy of the current treatments.

PMID: 26595716 [PubMed - in process]

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Can upper airway surgery for OSA protect against cardiovascular sequelae via effects on coagulation?

Can upper airway surgery for OSA protect against cardiovascular sequelae via effects on coagulation?

Acta Otolaryngol. 2015 Nov 23;:1-5

Authors: Zhan X, Li L, Wang N, Ge X, Pinto JM, Wu X, Wei Y

Abstract
CONCLUSION: Upper airway surgery is associated with salutary effects on the blood coagulation characteristics of OSA patients, a benefit that may be protective against cardiac and cerebrovascular morbidity and mortality.
OBJECTIVE: Increased blood coagulation is an important factor linking OSA and cardiovascular complications. Surgery is an important method to treat OSA, but the effect of surgery on blood coagulation in OSA patients is unknown.
METHODS: the authors performed a prospective clinical trial of adult OSA patients who underwent surgery from 2012-2014. Pre-operative and post-operative blood coagulation parameters and polysomnography (PSG) results were compared.
RESULT: There were 61 subjects. The total rate of success in curing OSA was 11.5%. The rate of response after surgery was 40.8%. Overall, the Apnea-Hypopnea Index (AHI) improved after surgery (from 39.8 3 ± 24.49 to 25.9 7 ± 18.53, p < 0.01). After surgery, serum platelet counts (PLT) decreased (from 242.5 ± 52.6 to 230.9 ± 40.7, p=0.01), and Fibrinogen (FIB) levels declined (from 262.5 ± 52.5 to 247.3 ± 44.4, p = 0.02). Other blood coagulation parameters also improved: prothrombin time (PT) (from 10.6 2 ± 0.62 to 10.8 6 ± 0.70, p=0.01), activated partial thromboplastin time (APTT) (from 26.9 8 ± 4.94 to 27.7 8 ± 3.02, p = 0.06), and Thrombin time (TT) (from 19.5 3 ± 0.84 to 20.1 1 ± 1.31, p < 0.01).

PMID: 26595664 [PubMed - as supplied by publisher]

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Brain Herniation in Neurofibromatosis with Dysplasia of Occipital Bone and Posterior Skull Base.

Brain Herniation in Neurofibromatosis with Dysplasia of Occipital Bone and Posterior Skull Base.

Case Rep Neurol Med. 2015;2015:816079

Authors: Rangarajan V, Mahore A, Patil M, Sathe P, Kaswa A, Gore S, Dharurkar P, Kawale J

Abstract
A 22-year-old female, a known case of neurofibromatosis 1 (NF1), presented with a congenital swelling in the left occipital region. She had developed recent onset dysphagia and localized occipital headache. Neuroradiology revealed a left occipital meningoencephalocele and a left parapharyngeal meningocele. This was associated with ventriculomegaly. She was advised on cranioplasty along with duraplasty which she denied. She agreed to a lumbar-peritoneal shunt. She described a dramatic improvement in her symptoms following the lumbar-peritoneal shunt. Occipital dysplasias, though uncommon, have been reported in the literature. We review this case and its management and discuss relevant literature on occipital dysplasias in NF1.

PMID: 26600957 [PubMed - as supplied by publisher]

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Eustachian Tube as a Landmark to the Internal Carotid Artery in Endoscopic Skull Base Surgery.

Eustachian Tube as a Landmark to the Internal Carotid Artery in Endoscopic Skull Base Surgery.

Otolaryngol Head Neck Surg. 2015 Nov 23;

Authors: Liu J, Sun X, Liu Q, Wang D, Wang H, Ma N

Abstract
OBJECTIVE: The purpose of this study was to probe the relationship between the eustachian tube and the internal carotid artery in skull base surgery by an intranasal endoscopic approach.
STUDY DESIGN: Cadaver study and illustrative cases.
SETTING: Minimally invasive surgery laboratory and operating room.
SUBJECTS AND METHODS: A series of 5 cadaveric heads were dissected to elaborate on the relevant surgical anatomy about the eustachian tube and the internal carotid artery. Three cases were presented to illustrate the application of our laboratory findings.
RESULTS: The bony-cartilaginous junction of the eustachian tube was just anterior to the first genu of the internal carotid artery by an intranasal endoscopic approach. The 3 patients in our study tolerated the procedure well and experienced no serious complications after surgery.
CONCLUSIONS: The anatomic data and clinical cases in this study confirmed that the eustachian tube is a consistent and reliable landmark to the internal carotid artery to avoid its injury in skull base surgery through the endoscopic endonasal route.

PMID: 26598497 [PubMed - as supplied by publisher]

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The Application of Surgical Navigation in the Treatment of Temporomandibular Joint Ankylosis.

The Application of Surgical Navigation in the Treatment of Temporomandibular Joint Ankylosis.

J Craniofac Surg. 2015 Nov;26(8):e776-80

Authors: Sun G, Lu M, Hu Q

Abstract
OBJECTIVE: The purpose of this study was to assess the safety and the accuracy of surgical navigation technology in the resection of severe ankylosis of the mandibular condyle with the middle cranial fossa.
METHODS: The computed tomography scan data were transferred to a Windows-based computer workstation, and the patient's individual anatomy was assessed in multiplanar views at the workstation. In the operation, the patient and the virtual image were matched by individual registration with the reference points which were set on the skull bone surface and the teeth. Then, the real-time navigation can be performed.
RESULTS: The acquisition of the data sets was uncomplicated, and image quality was sufficient to assess the operative result in 2 cases. Both of the operations were performed successfully with the guidance of real-time navigation. The application of surgical navigation has enhanced the safety and the accuracy of the surgery for bony ankylosis of temporomandibular joint.
CONCLUSIONS: The use of surgical navigation resulted in the promotion of accurate and safe surgical excision of the ankylosed skull base tissue.

PMID: 26595004 [PubMed - in process]

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[The relationship between the latency-intensity function of click ABR wave V and the audiogram configuration].

[The relationship between the latency-intensity function of click ABR wave V and the audiogram configuration].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 May;29(10):959-62

Authors: Song R, Tao Z

Abstract
OBJECTIVE: The latency-intensity function (LIF) of wave V from click ABR of some deaf children showed great variation. We attempted to find out the intrinsic reasons.
METHOD: The children recieved tone-burst ABR test.
RESULT: Frequencies from 0.5-4.0 kHz have been tested and the thresholds of tone-burst ABR were recorded. The average thresholds of steeply LIF children at 0.5-4.0 kHz were (93.13 ± 7.04), (79.37 ± 7.72), (69.38 ± 8.54) (66.25 ± 8.06) dB respectively, while the average thresholds of shallower LIF children at these 4 frequencies were (65.00 ± 7.32) (68.13 ± 6.55) (70.63 ± 6.80) (78.12 ± 8.34) dB respectively.
CONCLUSION: The results imply that the child with steeply LIF may have more hearing loss at frequencies 0.5 and 1 kHz than those with shallower LIF. LIF may predict the audiogram configuration.

PMID: 26596022 [PubMed - in process]

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[Treatment research progress on the treatment of neurofibromatosis type 2-associated vestibular schwannoma].

[Treatment research progress on the treatment of neurofibromatosis type 2-associated vestibular schwannoma].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 May;29(10):955-8

Authors: Zhao Y, Yang Q, Jiang Y

Abstract
Neurofibromatosis type 2 (NF2) is a dominantly inherited genetic condition. Bilateral vestibular schwannoma, which are benign tumors, composed of neoplastic Schwann cells that arise from the eighth cranial nerve, are the hallmark of NF2. Standard approaches for treatment of growing vestibular schwannoma include observation, surgical removal and radiation therapy. Molecular targeted therapies also present great prosperity in recent years. In this review, we summarize the latest progresses on the treatment of NF2-associated vestibular schwannoma.

PMID: 26596021 [PubMed - in process]

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[A case of huge extramedullary plasmacytoma in the retropharyngeal space].

[A case of huge extramedullary plasmacytoma in the retropharyngeal space].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 May;29(10):953-4

Authors: Qu G, Long Q, Yan X

Abstract
Extramedullary plasmacytoma (EMP) are often located in the head and neck region, commonly affecting the nasal cavity, tonsillar fossa and oral cavity but rarely the retropharyngeal space. In this report, a 60-year-old woman with large EMP in the retropharyngeal space is presented, who was diagnosed by pathology, bone marrow aspirate and computed tomography scan. The patient received operation and postoperative radiotherapy with dose of 50 Gy. At sixteen months follow-up, the patient was doing well with no signs of recurrence.

PMID: 26596020 [PubMed - in process]

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[Sudden deafness as the initial manifestation of chronic myelogenous leukemia: case report].

[Sudden deafness as the initial manifestation of chronic myelogenous leukemia: case report].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 May;29(10):952-3

Authors: Chen Y, An L, Jin G

Abstract
To study the pathogenesis of hearing loss in chronic myelogenous leukemia (CML). To report one case with CML whose first sign was sudden unilateral hearing loss. Sudden hearing loss in CML was presented with dramatic high white blood cell count in peripheral blood. Some cases of sudden hearing loss in CML may be improved or even cured by leukapheresis and intrathecal chemotherapy. The proposed pathogenesis for deafness in leukemia is due to hyperleukocytosis, hyperviscosity syndrome, leukemic infiltration and the inner ear hemorrhage. In treatment, clinicians should quickly reduce the number of white blood cells to lighten the tumor burden. Intrathecal injection of MTX and plasmapheresis is commonly used.

PMID: 26596019 [PubMed - in process]

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[Tuberculous granuloa of left auricle: case report].

[Tuberculous granuloa of left auricle: case report].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 May;29(10):951-2

Authors: He Y

Abstract
A femail patient was presented to our department for a dark red painless mass in the left auricle, which has progressively enlarged for one year. Pathological examination revealed granuloma change. Mycobacterium tuberculosis DNA test was positive. Tuberculin test revealed strong positive reaction. This case was diagnosed as tuberculous granuloma.

PMID: 26596018 [PubMed - in process]

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[Denucleated elevation treats auricle keloids].

[Denucleated elevation treats auricle keloids].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 May;29(10):949-50

Authors: Lv J

PMID: 26596017 [PubMed - in process]

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[Clinical observation the effect resection surgery by transferring the skin flap to repair the earlobe keloid].

[Clinical observation the effect resection surgery by transferring the skin flap to repair the earlobe keloid].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 May;29(10):948-9

Authors: Li E, Tian Y, Guo Q

PMID: 26596016 [PubMed - in process]

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[Effect of gene silencing of Bmi-1 on proliferation regulation of CD44+ nasopharyngeal carcinoma cancer stem-like cells].

[Effect of gene silencing of Bmi-1 on proliferation regulation of CD44+ nasopharyngeal carcinoma cancer stem-like cells].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 May;29(10):941-7

Authors: Xu X, Liu Y, Li D, Su J, Hu J, Lu M, Yi F, Reng J, Chen W

Abstract
OBJECTIVE: To investigate the effect of gene silencing of Bmi-1 on proliferation regulation of CD44+ nasopharyngeal carcinoma cancer stem-like cells (CSC-LCs).
METHOD: The sequence-specific short hairpin RNA lentivirus targeting at human Bmi-1 gene (LV-Bmi-1shRNA) was constructed and was used to infect CD44+ nasopharyngeal carcinoma cells which were sorted by flow cytometry. A lentiviral which included a random sequence was also designed to serve as a negative control. We employed fluorescence microscope and flow cytometry to detect infection efficiency; real-time PCR was used to detect Bmi-1 and its downstream gene while each protein expression level was confirmed by western blotting protocol; CCK-8 proliferation assay was applied to measure proliferation capacity; tumor spheroid assay was used to evaluate the self-renewal capacity. Colony formation assay was used to measure cell colony formation capability; flow cytometry analyzed cell cycle distribution.
RESULT: The constructed LV-Bmi-1shRNA successfully infected into the CD44+ nasopharyngeal carcinoma cells. The infection efficiency could reach above 95%; LV-Bmi-lshRNA effectively inhibited Bmi-1 mRNA and protein expression, while the downstream gene p16INK4a and p14ARF mRNA as well as protein expression level were upregulated (P < 0.05). Notablely, the proliferation, colony formation, self-renewal capabilities of the experimental group decreased significantly (P < 0.05). In addition, the cell cycle arrested at the G0-G1 phase.
CONCLUSION: Gene silencing of Bmi-1 inhibited the proliferation, colony formation and self-renewal capabilities of the CD44+ nasopharyngeal carcinoma CSC-LCs, inhibited the cell cycle processes, which may mediate through Bmi1-p16INK4a/p14ARF-p53 pathway. Our experimental results indicated that Bmi-1 gene may play an important role in the maintenance of the stem cell-like characteristics of CD44+ nasopharyngeal carcinoma cells. Bmi-1 gene may be a potential new target for the treatment of nasopharyng al carcinoma in the future.

PMID: 26596015 [PubMed - in process]

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[Multivariate analysis of prognostic makers in patients with nasopharyngeal carcinoma intreatment of radiotherapy combined with induction chemotherapy].

[Multivariate analysis of prognostic makers in patients with nasopharyngeal carcinoma intreatment of radiotherapy combined with induction chemotherapy].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 May;29(10):937-40

Authors: Liu J, Li S, Wang Y, Shi Y, Zhu L, Wu C

Abstract
OBJECTIVE: To observe the therapeutic effect of radiotherapy combined with TPF in patients with nasopharyngeal carcinoma (NPC) and to explore the influencing factors on prognosis of NPC.
METHOD: A retrospective analysis of 144 patients with nasopharyngeal carcinoma receiving radiotherapy combined with chemotherapy, from January 2006 to December 2011, was conducted. The survival analysis in patients with nasopharyngeal carcinoma were performed. The impact of age, sex, clinical stage, alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), lactate dehydrogenase (LDH), homocysteine (Hcy), uric acid, NK cell proportion, T cell proportion, Carbohydrate antigen on survival time was observed with univariate and multivariate methods.
RESULT: By the last follow-up, 9 cases were lost . The follow-up rate was 93.75 percent and the average follow-up time were 54.67 ±17.17 (37-88) months. The age, clinical stage, LDH, proportion of T cells and NK cells were independent factor in patients with NPC with univariate analysis (P < 0.01). COX regression multivariate analysis revealed that age, clinical stage and LDH were strong risk factor affecting prognosis (P < 0.01) and the proportion of NK cells and T cells were protective factors (P < 0.01).
CONCLUSION: Radiotherapy combined with TPF is more effective than radiotherapy alone in patients with nasopharyngeal carcinoma . Age, clinical stage and LDH may adversely influence the disease prognosis, and NK cells and T cell proportion may act as protective factors.

PMID: 26596014 [PubMed - in process]

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[The efficacy of intratympanic dexamethasone injection for the moderate and severe sudden deafness with BPPV].

[The efficacy of intratympanic dexamethasone injection for the moderate and severe sudden deafness with BPPV].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 May;29(10):934-6

Authors: Zhou X, Yu Y, Zhao Y, Wang Y, Liu Z, Liu Q

Abstract
OBJECTIVE: To evaluate the efficacy of intratympanic dexamethasone injection for the moderate and severe sudden deafness with BPPV.
METHOD: A total of 63 patients diagnosed with sudden sensorineural hearing loss with BPPV were treated through OPD. Patients were divided into three groups: 20 cases in intratympanic dexamethasone injection as initial treatment (group A); 18 cases in systemic hormone therapy group (group B); 25 cases in intratympanic dexamethasone injection as salvage treatment (group C). In addition, routine drugs were used to all patients.
RESULT: The overall effective rate of group A, B and C in hearing recovery was 60.0%, 38.9% and 48.0%, respectively: (1) No significant difference of hearing recovery was observed among three groups (P > 0.05); (2) A significant difference of hearing recovery was evidenced between group A and C (P < 0.05); (3) A significant difference of hearing recovery was evidenced between group A and C (P < 0.05); (4) No statistically significant difference was found in the hearing recovery between group B and C (P > 0.05).
CONCLUSION: Our data showed that intratympanic dexamethasone should be used as initial therapy for treating the moderate and severe sudden deafness with BPPV.

PMID: 26596013 [PubMed - in process]

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[Clinical observation of the γ-globulin levels when Benign paroxysmal positional vertigo is attacking].

[Clinical observation of the γ-globulin levels when Benign paroxysmal positional vertigo is attacking].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 May;29(10):931-3

Authors: Yuan H, Song Y, Zhang D

Abstract
OBJECTIVE: To observe the characteristics of serum protein in patients with benign paroxysmal positional vertigo (BPPV) during the symptomatic period.
METHOD: Fifty-five patients with BPPV and 58 control subjects were enrolled in the study. All the patients underwent the Dixe-Hallpike and Roll maneuver to confirm the type of BPPV. The average time of onset was (1.0 ± 0.8)days in the group of BPPV. The clinical features and the laboratory tests of serum protein electrophoresis, blood counts, and liver and kidney function were performed in both groups.
RESULT: The levels of serum albumin (Alb), α1 globulin, α2 globulin and β globulin of BPPV group did not differ statistically in the two groups (P > 0.05); The γ-globulin levels were significantly higher in patients with BPPV than in controls (P < 0.05).
CONCLUSION: The γ-globulin levels are increased when BPPV is attacking.

PMID: 26596012 [PubMed - in process]

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